But Seriously: Clowning in Children's Mental Health

Abstract

Dr. Lilly Pad was conducting an Eye Test. She would hold up a brown letter ‘‘E’’ and ask the kids what it was: a ‘‘Brownie.’’ She’d hold up another, with a red letter ‘‘E’’ and say ‘‘Are youIRed E?’’ Lots of word play. There was a teenager sitting in a corner. He hadn’t been saying anything before this, but during this game, he was the first to get it, each and every time. An ‘‘I’’ written in the color black? A black eye. Every time Dr. Lilly Pad held one up, he got it. He showed us who he was and what he knew, and afterwards the staff told us that that was when they learned who this kid was.V Dr. Chester Drawers (personal communication, 2008) In this Clinical Perspectives column, we consider what clowns might teach us about working with children and adolescents and what roles clowning might play in pediatric mental health. After all, laughter, joy, and play are an essential part of childhood, and clowns are a nearly ubiquitous source of laughter, now even performing on a regular basis in some hospitals. Mental health providers must be either formally or intuitively attuned to a child’s laughter, in part because most of the disorders of childhood and adolescence will in some way affect the core human behavior of laughter. Children who do not smile because they are anhedonic or who do not engage in developmentally expected types of play because they are anxious may find themselves in our offices. The ease with which a child smiles or laughs is a natural part of an assessment of a child’s affect. How a child engages in play and jokes gives us insight into their development. Attention to such characteristics may also be crucial to the therapeutic process. 1